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Countertransference
In psychotherapy, countertransference is a condition where the therapist, as a result of the therapy sessions, begins to transfer the therapist's own unconscious feelings to the patient. For example, a therapist might have a strong desire for a client to get all 'A's' in university because the client reminds her of her children at that stage in life, and the anxieties that the therapist experienced during that time. Countertransference is also sometimes defined as the entire body of feelings that the therapist has toward the patient, and also includes cases where the therapist literally takes on the suffering of his/her patient Jung, The psychology of the transference, pg 8. In the most extreme of cases, it can result in the therapist taking on the neurosis or psychosis of the patient, such as bouts of paranoia or psychotic intervals, illustrated by Jung in the case of schizophrenia.Jung, The psychology of the transference, pg 8 Countertransference is defined in opposition to transference, where a person in therapy begins to transfer feelings (whether positive or negative) to the therapist. For example, the person in therapy may begin to look at the therapist as if the therapist were the patient's mother, transferring their feelings for the real mother to the therapist. This is considered a positive sign in psychoanalytic therapy, showing that the patient is making progress. The therapist emotional involvement in this way can have a very distorting effect on the process of therapy and should be discussed in clinical supervision so its effects can be monitored and mitigated. It is also true that the effects can be benignReber, AS & Reber ES (2001). Dictionary of Psychology, 3rd ed. London:Penguin. In On Becoming a Counselor, Eugene Kennedy states that countertransference has the potential to be present in any counseling relationship On Becoming A Counselor, Revised Edition : A Basic Guide for Nonprofessional Counselors and Other Helpers by Eugene Kennedy. He states that it is often one of the biggest challenges for a new counselor to overcome, and while there is no way to totally overcome the problem of counter-transference (since as humans we all form opinions of others) learning to not let countertransference affect a counseling relationship is key. The mantra "only connect" is often associated with this effect. Countertransference can also be seen as a useful phenomenon for the therapist because it can allow them to gain insight into the kinds of emotions and reactions the client often tends to induce in others. In this way, the countertransference is a welcomed phenomenon which can prove invaluable to the clinical relationship. In this way, countertransference is related to the psychoanalytic concept of projective identification, a defense mechanism in which the client projects onto and induces their own inner experience within the clinician. A related concept is counterresistance, which includes therapist behaviours that influence the therapeutic process through such "blockings" as (hostile) silence, attempting to change the subject, or otherwise preventing unwanted ideas or feelings from rising to the fore. Counterresistance can result from a therapist's colluding with the patient's resistance to explore or work through unpleasant issues but can also originate exclusively from the therapist. An example would be an overweight therapist consistently steering an equally overweight client away from discussions about weight loss. Early formulations The phenomenon was first defined publicly by Sigmund Freud in 1910 ("The Future Prospects of Psycho-Analytic Therapy") as being "a result of the patient's influence on physician's unconscious feelings;" although Freud had been aware of it privately for some time, writing to Jung for example in 1909 of the need "to dominate 'counter-transference', which is after all a permanent problem for us".W. McGuire ed., The Freud/Jung Letters (1974) p. 231 Freud stated that since an analyst is a human himself he can easily let his emotions into the clientNeil R. Carlson & C.Donald Heth page 595Laplanche, J & Pontalis, J-B. (1973) The Language of Psycho-Analysis p. 92 Because Freud saw the countertransference as a purely personal problem for the analyst, he rarely referred to it publicly, and did so almost invariably in terms of a "warning against any countertransference lying in wait" for the analyst, who "must recognize this countertransference in himself and master it".Freud, quoted in Peter Gay, Freud: A life for our time(London 1989) p. 302 and p. 254 The potential danger of the analyst's countertransference - 'In such cases the patient represents for the analyst an object of the past on to whom past feelings and wishes are projected'Annie Reich, quoted in Patrick Casement, Further learning from the patient (London 1997), p. 177n - became widely accepted in psychodynamic circles, both within and without the psychoanalytic mainstream. Thus, for example, Jung warned against 'cases of counter-transference when the analyst really cannot let go of the patient...both fall into the same dark hole of unconsciousness'.C. G. Jung, Analytical Psychology: its Theory and Practice(London 1976) p. 159 and p. 157 Similarly Eric Berne stressed that 'Countertransference means that not only does the analyst play a role in the patient's script, but she plays a part in his...the result is the "chaotic situation" which analysts speak of'.Eric Berne, What Do You Say after You Say Hello? (London 1975), p. 352 Again, Lacan acknowledged of the analyst's 'countertransference...if he is re-animated the game will proceed without anyone knowing who is leading'.Jacques Lacan, Ecrits: A Selection(London 1997) p. 229-230 In this sense, the term includes unconscious reactions to a patient that are determined by the psychoanalyst's own life history and unconscious content; it was later expanded to include unconscious hostile and/or erotic feelings toward a patient that interfere with objectivity and limit the therapist's effectiveness. For example, a therapist might have a strong desire for a client to get all 'A's' in university because the client reminds her of her children at that stage in life, and the anxieties that the therapist experienced during that time. Even in its most benign form, such an attitude could lead at best to 'a "countertransference cure"...achieved through compliance and a "false self" suppression of the patient's more difficult feelings'.Patrick Casement, On Learning from the Patient (London 1990), p. 174 Another example would be a therapist who didn't receive enough attention from her father perceiving her client as being too distant and resenting him for it. In essence, this describes the transference of the treater to the patient, which is referred to as the “narrow perspective.” Middle years As the 20th century progressed, however, other, more positive views of countertransference began to emerge, approaching a definition of countertransference as the entire body of feelings that the therapist has toward the patient. Jung explored the importance of the therapist's reaction to the patient through the image of the wounded physician: 'it is his own hurt that gives the measure of his power to heal'.Jung quoted in Anthony Stevens, Jung (Oxford 1994) p. 110 Heinrich Racker emphasised the threat that 'the repression of countertransference...is prolonged in the mythology of the analytic situation'.Heinrich Racker, Transference and Countertransference (London 1982) p. 131 Paula Heimann highlighted how the 'analyst's countertransference is not only part and parcel of the analytic relationship, but it is the patient's creation, it is part of the patient's personality'.Casement, Further learning p. 12 As a result, 'counter-transference was thus reversed from being an interference to becoming a potential source of vital confirmation'.Robert Hinshelwood and Susan Robinson, Introducing Melanie Klein (Cambridge 2006) p. 151 The change of fortune 'was highly controversial. Melanie Klein disapproved on the grounds that poorly analyzed psycho-analysts could excuse their own emotional difficulties' thereby; but among her younger followers 'the trend within the Kleinian group was to take seriously the new view of counter-transference'Hishelwood/Robinson - Hanna Segal warning in typically pragmatic fashion however that 'Countertransference can be the best of servants but is the most awful of masters'.David Bell, Reason and Passion (London 1997) p. 30 Late twentieth-century paradigm By the last third of the century, a growing consensus appeared on the importance of 'a distinction between "personal countertransference" (which has to do with the therapist) and "diagnostic response" - that indicates something about the patient...diagnostic countertransference'.Casement, Further learning p. 8 and p. 165 A new belief had come into being that 'countertransference can be of such enormous clinical usefulness....You have to distinguish between what your reactions to the patient are telling you about his psychology and what they are merely expressing about your own'."Aaron Green", quoted in Janet Malcolm, Psychoanalysis: the impossible profession(London 1988), p. 115 Awareness of the distinction between ' neurotic countertransference - which...Fordham calls illusory countertransference - the personal countertransference or narrow perspective - 'and countertransference proper 'Mario Jacoby, The Analytic Encounter (Canada 1984) p. 38 had come (despite a wide range of terminological variation) to transcend individual schools. The main exception is that for 'most psychoanalysts who follow Lacan's teaching...counter-transference is not simply one form of resistance, it is the ultimate resistance of the analyst'.Jean-Michel Quinodoz, Reading Freud (London 2005) p. 72 The contemporary understanding of countertransference is thus generally to regard countertransference as a “jointly created” phenomenon between the treater and the patient. The patient pressures the treater through transference into playing a role congruent with the patient’s internal world. However, the specific dimensions of that role are colored by treater’s own personality. Countertransference can be a therapeutic tool when examined by the treater to sort out who is doing what, and the meaning behind those interpersonal roles (The differentiation of the object’s interpersonal world between self and other). Nothing in the new understanding alters of course the need for continuing awareness of the dangers in the narrow perspective - of 'serious risks of unresolved countertransference difficulties being acted out within what is meant to be a therapeutic relationship';Casement, Learning but 'from that point on, transference and counter-transference were looked upon as an inseparable couple..."total situation"'.Quinodoz, Reading Freud p. 71 Twenty-first century developments Further developments in the current century might be said to be the increased recognition that 'Most countertransference reactions are a blend of the two aspects', personal and diagnostic, which require careful disentanglement in their interaction; and the possibility that nowadays psychodynamic counsellors use countertransference much more than transference − 'another interesting shift in perspective over the years'.Michael Jacobs, Psychodynamic Counselling in Action(London 2006), p. 146 One explanation of the latter point might be that because 'in object relations therapy...the relationship is so central, "countertransference" reactions are considered key in helping the therapist to understand the transference',Jan Grant and Jim Crawley, Transference and Projection (Buckingham 2002), p. 50 something appearing in 'the post-Kleinian perspective...as Indivisible transferencecountertransference'.James S. Grotstein, But at the Same Time and on Another Level (London 2009) p. 38 Body-centred countertransference Irish psychologists at NUI Galway and University College Dublin Egan, J. & Carr, A. (2005). Burnour in female counsellor/therapists of the NCS: Studies I,II and III. Papers presented at the 35th Annual conferenceof the psychological society of Ireland, Derry, Nov 17-20thEgan, J. & Carr, A. (2008). Body-centred countertransference in female trauma therapists. Eisteach, 8, 22-27. have recently begun to measure body-centred countertransference in female trauma therapists using their recently developed 'Egan and Carr Body Centred Countertransference Scale', a sixteen symptom measure. High levels of body-centred countertransference have since been found in both Irish female trauma therapists and clinical psychologists.Booth, A., Trimble, T., & Egan, J. (2010). body-centred countertransference in a sample of Irish Clinical Psychologists. The Irish Psychologist, 36, 284-289. This phenomenon is also known as 'somatic countertransference' or 'embodied countertransference' and links to mirror neurons and automatic somatic empathy for others due to the actions of these neurons have been hypothesised.Egan, J. & Carr, A. (2008). Body-centred countertransference in female trauma therapists. Eisteach, 8, 22-27Rothschild, B. (2006). Help for the helper: self-care strategies for managing burnout and stress. London: W. W. Norton & Company. ----- See also * Acting in *Body-centred countertransference *Enactments *Empathy *Joseph J. Sandler *Mirror neurons *Negative therapeutic reaction *Professional client sexual relations *Projective Identification *Psychotherapeutic processes *Psychotherapeutic transference *Role suction *Sexual countertransference *Sexual transference *Therapeutic relationship References & Bibliography Key texts Books *Gabbard, G.; Wilkinson, S.: Management of Countertransference with Borderline Patients; Northdale, NJ: Jason Aronson, Inc., 1994, 2002. *Tansey, M., & Burke, W. (1989). Understanding countertransference: From projective identification to empathy. Hillsdale, NJ: The Analytic Press. *Wolstein, B. (1988). Essential papers on countertransference. New York: New York University Press. Chapters *Heimann, P. (1949). On counter-transference. In R. Langs (Ed.), Classics in psychoanalytic technique (pp. 139-142). Northvale, NJ: Jason Aronson, 1990. *Winnicott, D.W. (1947). Hate in the countertransference. In: Through paediatrics to psychoanalysis (pp. 194-203). New York: Basic Books, 1975. *Winnicott, D.W. (1960). Counter-transference. In: The maturational processes and the facilitating environment (pp. 158-165). New York: International Universities Press, 1965. Papers *Burke, W., & Tansey, M. (1991). Countertransference disclosure and models of therapeutic action. Contemporary Psychoanalysis, 27, 351-384. *Greenberg, J. (1991). Countertransference and reality. Psychoanalytic Dialogues, 1(1), 52-73. *Jacobs, T. (1986). On countertransference enactments. Journal of the American Psychoanalytic Association, 4, 224-255. *Little, M. (1951). Counter-transference and the patient's response to it. International Journal of Pychoanalysis, 32, 32-40. *Racker, H. (1972). The meanings and uses of countertransference. Psychoanalytic Quarterly, 41, 487-506. *Schwaber, E.A. (1992). Countertransference: The analyst's retreat from the patient's vantage point. International Journal of Psychoanalysis, 73, 349-361. *Tower, L.E. (1956). Countertransference. Journal of the American Psychoanalytic Association, 4, 224-255. Additional material Books *Dalenberg, C. J. (2000). Countertransference and trauma resolution. Washington, DC: American Psychological Association. Papers *Google Scholar External links *The psychotherapist in context: Countertransference - How the therapist’s personal life, roles and social environment influence therapy Category:Interpersonal interaction Category:Psychotherapeutic processes Category:Therapeutic relationship Category:Countertransference